Individual
GRETCHEN MARIE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC LAMFT
Contact information
Practice address
1719 MERRILL DR, LITTLE ROCK, AR 72212-4009
(501) 663-2199
Mailing address
1827 MILL ST, CONWAY, AR 72034-3827
(479) 561-2934
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A1806063
AR
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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